Older persons are undergoing hip and knee replacement surgery in increasing numbers and our aging population will see this figure steadily rise. Although outcomes are generally positive after this surgery there is limited data investigating the incidence of falls in the 12 months after discharge. Falls are often associated with injury and loss of function and may lead to reduced independence, health related quality of life and death. There are no robust large population-based studies which have examined these outcomes and the economic cost of falls in the post discharge population.
Our study aims to measure the incidence and health care cost of falls in the 12 months after discharge; and to identify risk factors predictive of falls in the 12 months after hospital discharge and health related quality of life.
Methods:
Four hundred and thirty-four patients who underwent total hip or total knee replacement were recruited. Monthly telephone follow-up for 12 months were undertaken using a number of validated assessment tools administered at different time points. Optional semi-structured interviews after completion of the 12 month follow-up were undertaken to explore participants’ perceptions and consequences of falls as well as falls prevention in the context of their return to independence.
Results:
Generalised linear mixed modelling will be used to examine falls outcomes as well as patient and clinical characteristics predictive of falls in the 12 months after discharge.
Analyses of Medicare and Pharmaceutical Benefit Scheme data will be undertaken for both fallers and non-fallers to estimate healthcare utilisation costs directly attributable to falling.
Telephone interviews will be digitally recorded, transcribed verbatim and analysed using latent and manifest content analysis to understand a participants motivation to engage in falls prevention strategies.
Conclusion:
Understanding why patients fall after this common surgical procedure will enable risk stratification and the implementation of targeted risk prevention strategies prior to hospital discharge.